Provider Demographics
NPI:1215164918
Name:KIRCHNER SENIOR SERVICES LLC
Entity type:Organization
Organization Name:KIRCHNER SENIOR SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FRANCHISE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:KIRCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-317-3037
Mailing Address - Street 1:2475 S AVE A
Mailing Address - Street 2:STE C
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7168
Mailing Address - Country:US
Mailing Address - Phone:928-317-3037
Mailing Address - Fax:928-317-0667
Practice Address - Street 1:2475 S AVE A
Practice Address - Street 2:STE C
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7168
Practice Address - Country:US
Practice Address - Phone:928-317-3037
Practice Address - Fax:928-317-0667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20366595253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care